I was very glad to have the opportunity to present with Bridgett Piernik-Yoder at last Friday’s Grand Rounds for the School of Health Professions. We discussed social media tools and their use in the health professions and education, along with a description of what’s been going on here at the Health Science Center for the past year or so, since PrISM began — and we had some great discussions about what the next steps might be for the SHP and the University as a whole.

Presenting those Grand Rounds reminded me about an excellent item I’ve been meaning to post here, so I’ll do it right now. Dr Bryan Vartabedian is a pediatric gastroenterologist at Texas Children’s Hospital/Baylor College of Medicine, whose 33 Charts blog is a constant source of thought-provoking and well-considered observations on the use of social media in medicine. On December 2, 2011, he presented Pediatric Grand Rounds at Texas Children’s Hospital on physicians and social media. A few days later, he posted a narrative version of his presentation on his 33 Charts blog, under the title “Physicians, Risk and Opportunity in the Digital Age”. It’s a great piece and highly worthwhile reading for physicians who are both new and experienced in the social media realm. A few key nuggets I found particularly interesting:

“For the better part of modern civilization our role as physician has centered around privileged access to information and knowledge. But the web has created a type of disintermediation. Patients can do more on their own. They can access information and make certain judgments. They can share information and adjust what they’re doing based on the input of others. And the physician encounter is evolving as a more narrowly defined element in an individual’s quest to understand their condition and get better. This health 2.0 element is fueled by social media. So in effect, what we see are a variety of social and technological forces conspiring to redefine the physician. I believe that how we react professionally to these forces over the next generation will help shape who we become.”

“With respect to social media, I see two challenges facing our profession: patient privacy and professionalism. There are others we could identify but I think that these two occupy the minds of those watching doctors in public. Privacy is relatively easy. Professionalism is remarkably difficult. I’ve noticed that health institutions tend to focus on patient privacy almost at the exclusion of professionalism.”

“The way to train the next generation is not to prohibit the media but rather to teach how we can live with it as professionals.”

“Are physicians morally obligated to participate in social dialog? I first raised this question in 2009 and it generated a lot of dialog. I’ll submit to you that as physicians we are obligated to create, curate and talk… It’s interesting that as physicians we are the first to criticize what patients read but we’re the last to create it. Public education is part of our charge. We have an obligation to do better.”

This question of professionalism and how it plays out in social media space is an area of very active and interesting discussions. Dr Mark Ryan, a family medicine doctor and assistant professor at VCU, responded to Dr Vartabedian’s Grand Rounds with a blog post of his own. Dr Ryan agreed with most of Dr Vartabedian’s ideas, but disagreed about some of the nuances of what constitutes professional behavior in a public space like social media. He notes that professionalism does not always demand restraint; for some, it may also mean more radical transparency, advocacy, and humanity. He also disputes Dr Vartabedian’s position that anonymous (or pseudonymous) postings online are practically always less effective, less useful and less professional than identified ones:

“I do think there can be value in anonymity in certain cases. What if a physician is criticizing the practices of a major insurer, or their employer? What if someone wishes to discuss a sensitive personal issue without self-disclosing? Even if this cloak of secrecy is not foolproof, it can provide a safer space for such discussions. I think the content of an account will dictate whether or not it is trusted or considered valuable–not just whether or not it is anonymous… Whistle-blowers, agitators, and critics may all have important perspectives and contributions to an issue under discussion, or might call attention to larger problems. Raising these issues might strike some as unprofessional…raising the question of who will decide professional vs. unprofessional conduct?”

I encourage you to read and consider both posts as we think about what professionalism looks like in this new world. Where do you find yourself on these issues right now? In what ways does this new reality challenge your comfort zones?